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Post radical prostatectomy PSA
flapwing posted:
I had a bilateral nerve sparing radical prostatectomy 23 June... today my PSA is 0.80 ug/l and my Free PSA is 0.08 ug/l. Which score should I be considering? Is the 0.80 above the threshold for recurrence?
az4peaks2 responded:
Hi Flapwing, - You must not be in the United States (U.S.). It is customary in the U.S. to report PSA results in nanograms per millilitre (ng/ml), so the less familiar micrograms per litre (ug/L) is likely to confuse many but the most PSA knowedgeable readers.

To specifically answer your question, YES the 0.80 ug/L is MUCH higher than the usual clinically "undetectable" post-surgical Standard that is normally used with Total PSA assays, which is LESS THAN 0.1 (in either ng/ml or ug/L) on the "Standard" PSA test (<0.1ng/ml), which reports results to a sensitivity of tenths of a millilitre (ml).

When Hyper- or Ultra-Sensitive PSA assays (reporting in the Hundredths or Thousandths of a ml) are used, they can often report actual readings, but at such low levels of sensitivity that it INCREASES the potential for, often, clinically meaningless variations in such readings. Such insignificant variations can cause substantially increased, and often needless PSA anxiety on the part of many Patients.

Since you report your result to 2 decimal points, I ASSUME, that you had the more sensitive assay employed, but assuming the decimal point is in the correct location, the 0.8 result is unfavorably significant regardless of sensitivity level involved or how many zeroes are added BEHIND it.

If the the result had been found to be .08 or .008 ug/L, it would have been considered clinically "undetectable" and you would have been considered, presently, PCa free.

Free PSA is not usually employed for ROUTINE post-surgery PSA monitoring, as Total PSA is more indicative of recurrence, since Free PSA is usually not reliably accurate at such extremely low Total PSA readings.

I hope this has helped your (and other readers) understanding of post-surgery PSA monitoring and I will be happy to respond to any questions or clarifications desired. Good luck! - (aka) az4peaks
az4peaks2 replied to az4peaks2's response:
Hi again flapwing, - To clear-up the relative relationship of ug/L to ng/ml, it is as follows:

Both RATIO"S are equal, so no conversion would be necessary.

The RATIO of microgram per Liter (ug/L) is the SAME as nanogram per milliliter (ng/ml), since each of the latter is 1000th of the former. - (aka) az4peaks

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